Daniela Gabrielli

Time-domain analysis of scrotal thermoregulatory impairment in varicocele

Varicocele is a common male disease defined as the pathological dilatation of the pampiniform plexus and scrotal veins with venous blood reflux. Varicocele usually impairs the scrotal thermoregulation via a hemodynamic alteration, thus inducing an increase in cutaneous temperature. The investigation of altered scrotal thermoregulation by means of thermal infrared imaging has been proved to be useful in the study of the functional thermal impairment. In this study, we use the Control System Theory to analyze the time-domain dynamics of the scrotal thermoregulation in response to a mild cold challenge. Four standard time-domain dynamic parameters of a prototype second order control system (Delay Time, Rise Time, closed poles locations, steady state error) and the static basal temperatures were directly estimated from thermal recovery curves. Thermal infrared imaging data from 31 healthy controls (HCS) and 95 varicocele patients were processed. True-positive predictions, by comparison with standard echo color Doppler findings, higher than 87% were achieved into the proper classification of the disease stage. The proposed approach could help to understand at which specific level the presence of the disease impacts the scrotal thermoregulation, which is also involved into normal spermatogenesis process.

Embolization of Bleeding Pulmonary Arterial Pseudoaneurysm in a Woman with Infective Endocarditis

Pulmonary arterial pseudoaneurysm is a rare but life-threatening complication of infective endocarditis. This report describes a case of bleeding pulmonary arterial pseudoaneurysm in a young, drug-addicted woman with tricuspid annuloplasty after infective endocarditis that was promptly identified by computed tomography pulmonary angiography and successfully treated using coil embolization. Perfusion scintigraphy at 30 days confirmed the safety of endovascular treatment.

Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice

Magnetic resonance imaging (MRI) allows to non-invasively evaluate rectal cancer staging and to assess the presence of “prognostic signs” such as the distance from the anorectal junction, the mesorectal fascia infiltration and the extramural vascular invasion. Moreover, MRI plays a crucial role in the assessment of treatment response after chemo-radiation therapy, especially considering the growing interest in the new conservative policy (wait and see, minimally invasive surgery). We present a practical overview regarding the state of the art of the MRI protocol, the main signs that radiologists should consider for their reports during their clinical activity and future perspectives.Teaching Points• MRI protocol for rectal cancer staging and re-staging.• MRI findings that radiologists should consider for reports during everyday clinical activity.• Perspectives regarding the development of latest technologies.

Extremely Rare Case of Vascular Dysphagia in an Elderly Man

A 68-year-old man was admitted to our hospital for chronic dysphagia for solid foods and weight loss. Clinical examination on hospital admission did not show any significant alterations. Specifically, neither lymphadenopathy or thyroid enlargement, abdominal masses, or skin abnormalities that suggested connective tissue disorders were found. Furthermore, chest radiography performed at admission did not show any abnormality (Figure 1). The barium esophagram, a highly evaluable investigation in patients with suspected esophageal dysphagia, demonstrated an extrinsic compression on the posterior wall of the upper thoracic esophagus (Figure 2). Subsequently, 3-dimensional contrast-enhanced magnetic resonance angiography (Figure 3) showed the right-sided aortic arch, from which an abnormal vascular branch originated, encircling the …

Aneurisma dell’aorta addominale rotto in paziente sottoposto ad EVAR ( Endovascular Aneurysm Repair )

1. Trattamento endovascolare di aneurisma dell’aorta addominale (AAA) mediante posizionamento di stent-graft aortico biforcato. 2. L’immagine TC, eseguita senza mdc, consente di evidenziare il versamento retroperitoneale iperdenso, distribuito prevalentemente in sede pararenale posteriore sinistra, indicativo di sanguinamento in atto. 3. Endoleak, ossia riperfusione della sacca aneurismatica esclusa. 4. La causa del dolore lombare acuto e dell’anemia ingravescente e rappresentata dalla rottura dell’aorta ad-dominale in pregresso posizionamento di stent-graft aorto-bisiliaco secondario ad endoleak di tipo III, da migrazione delle branche iliache.

Fistola aorto-enterica in pregresso innesto aorto-bisiliaco

1. Le immagini senza mdc consentono di riconoscere la protesi chirurgica (formazione circolare iperdensa all’esame di base), la stretta contiguita tra l’aorta e l’ansa intestinale (seconda porzione duodenale) e la presenza, in quest’ultima, di contenuto liquido tenuemente iperdenso (40-60 UH). 2. La fase arteriosa consente di valutare la pervieta della protesi e distinguere il lume protesico dalla sacca aneurismatica residua. E evidente uno stravaso di mdc (freccia) nel contesto della sacca aneurismatica residua, a partenza dalla parete posteriore della protesi, in sede anastomotica prossimale: il nome della lesione e leakage periprotesico in sede anastomotica prossimale. 3. L’immagine in fase tardiva evidenzia un enhancement simil-aortico del contenuto liquido presente nel lume intestinale. Tale reperto semeiologico risulta patognomonico della patologia in esame. 4. Fistola aorto-enterica, in sede anastomotica prossimale, di pregresso innesto aorto-bisiliaco.

Pseudo-aneurismi splenici post-traumatici

1. In fase arteriosa si evidenziano delle raccolte di mdc a margini definiti nel contesto del parenchima splenico, che non mostrano incremento di enhancement nelle ulteriori fasi eseguite. 2. La semeiotica TC delle lesioni descritte pone la diagnosi differenziale tra angiomi, pseudo-aneurismi post-traumatici e fistole artero-venose. 3. Pseudo-aneurismi post-traumatici. 4. Ematoma, lacerazione, emorragia in atto e le lesioni vascolari.

Aneurisma dell’aorta addominale con fissurazione del trombo

1. Aneurisma dell’aorta addominale sottorenale. 2. No. Non si evidenziano ne imbibizione del tessuto adiposo retroperitoneale ne segni di versamento retro-peritoneale iperdenso all’esame di base. 3. L’esame di base documenta un’area tenuemente e disomogeneamente iperdensa nel contesto della sacca aneurismatica, a morfologia semilunare, indicativa di trombo instabile. Un aneurisma con un trombo instabile puo essere classificato come aneurisma ad elevato rischio di rottura. 4. Aneurisma dell’aorta addominale sottorenale fissurato.